Patient, male 40y old, consults for a pain in the right
tonsilar region. The clinical examination shows a 2 cm
lesion of the right tonsil spreading in the anterior
tonsillar pillar ( palatoglossus muscle). One 2cm ADP is
palpated in the sub-mandibular homolateral aera.
A MRI examination is done using the following sequences :
T1w SE axial pre and post Gd DOTA, T2w FSE coronal. What is
the T stage of this tumour ?
It is a T4 tumour because of its extension into the deep
muscles of the tongue.
Staging criteria for primary squamous cell carcinoma of the
oropharynx:
T1: tumour is 2 cm or less in its greatest dimension.
T2: tumour is more than 2 cm but not more than 4 cm in its
greatest dimension.
T3: tumour is more than 4 cm in its greatest dimension.
T4: tumour invades adjacent structures, including bone
(mandible or maxilla), soft tissues of the neck, or deep
(extrinsic) muscles of the tongue.
A biopsy showed a squamous cell carcinoma of the right
tonsil.
The patient was treated by chemo- and radiotherapy and presented with a total remission after one year follow-up.